{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T21:42:29Z","timestamp":1774129349059,"version":"3.50.1"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"Supplement_B","license":[{"start":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T00:00:00Z","timestamp":1682035200000},"content-version":"vor","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Ministry of Health"},{"DOI":"10.13039\/100007365","name":"Fondazione IRCCS Policlinico San Matteo","doi-asserted-by":"crossref","award":["221-rcr2000b-8"],"award-info":[{"award-number":["221-rcr2000b-8"]}],"id":[{"id":"10.13039\/100007365","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100007365","name":"Fondazione IRCCS Policlinico San Matteo","doi-asserted-by":"crossref","award":["888-rcr2017i-71"],"award-info":[{"award-number":["888-rcr2017i-71"]}],"id":[{"id":"10.13039\/100007365","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"crossref","award":["GGP08238"],"award-info":[{"award-number":["GGP08238"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"crossref","award":["CP2_14\/2018"],"award-info":[{"award-number":["CP2_14\/2018"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Spontaneous coronary artery dissection (SCAD) is an under-recognized cause of acute coronary syndrome that predominantly affects women in adulthood and is the leading cause of acute myocardial infarction in pregnancy. The most common clinical presentation is ST-segment elevation myocardial infarction (STEMI) or non-STEMI, followed by cardiogenic shock (\u223c2%), sudden cardiac death (0.8% in autopsy series), cardiac arrest, ventricular arrhythmias (\u223c5%), and Takotsubo syndrome. The prevalence of SCAD in the general population is largely uncertain due to underdiagnosis. Oral contraceptives, post-menopausal therapy, and infertility treatments are recognized associated factors. The pathological substrates (fibromuscular dysplasia) and triggers (especially emotional stress) are commonly present in affected women. The few cases with a precise genetic aetiology occur in the context of syndromic and non-syndromic connective tissue diseases. The only true certainty in SCAD is the overwhelming prevalence in women. The first event as well as the recurrence (up to 30%, which varies depending on the definition) is largely unpredictable. The treatment strategy is highly individualized and requires extensive additional study in order to optimize outcomes and prevent major adverse cardiovascular events in affected individuals. We have known about SCAD for nearly a century, but we still do not know how best to prevent, diagnose, and treat it, making SCAD a highly important and unmet clinical need.<\/jats:p>","DOI":"10.1093\/eurheartjsupp\/suad059","type":"journal-article","created":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T18:03:31Z","timestamp":1682100211000},"page":"B7-B11","source":"Crossref","is-referenced-by-count":7,"title":["Spontaneous coronary artery dissection: an unpredictable event"],"prefix":"10.1093","volume":"25","author":[{"given":"Alexandra","family":"Smirnova","sequence":"first","affiliation":[{"name":"Transplant Research Area and Centre for Inherited Cardiovascular Diseases, Scientific Department, Fondazione IRCCS Policlinico San Matteo , Pavia , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Flaminia","family":"Aliberti","sequence":"additional","affiliation":[{"name":"Transplant Research Area and Centre for Inherited Cardiovascular Diseases, Scientific Department, Fondazione IRCCS Policlinico San Matteo , Pavia , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Cavaliere","sequence":"additional","affiliation":[{"name":"Transplant Research Area and Centre for Inherited Cardiovascular Diseases, Scientific Department, Fondazione IRCCS Policlinico San Matteo , Pavia , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilaria","family":"Gatti","sequence":"additional","affiliation":[{"name":"Transplant Research Area and Centre for Inherited Cardiovascular Diseases, Scientific Department, Fondazione IRCCS Policlinico San Matteo , Pavia , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viviana","family":"Vilardo","sequence":"additional","affiliation":[{"name":"Transplant Research Area and Centre for Inherited Cardiovascular Diseases, Scientific Department, Fondazione IRCCS Policlinico San Matteo , Pavia , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmelina","family":"Giorgianni","sequence":"additional","affiliation":[{"name":"Transplant Research Area and Centre for Inherited Cardiovascular Diseases, Scientific Department, Fondazione IRCCS Policlinico San Matteo , Pavia , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Cassani","sequence":"additional","affiliation":[{"name":"Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia , Pavia , Italy"},{"name":"Unit of Obstetrics and Gynecology, IRCCS Policlinico S. Matteo Foundation , Pavia , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"Repetto","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Fondazione IRCCS Policlinico S. Matteo , Pavia , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nupoor","family":"Narula","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Weill Cornell Medical College , New York , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Giuliani","sequence":"additional","affiliation":[{"name":"Transplant Research Area and Centre for Inherited Cardiovascular Diseases, Scientific Department, Fondazione IRCCS Policlinico San Matteo , Pavia , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Urtis","sequence":"additional","affiliation":[{"name":"Transplant Research Area and Centre for Inherited Cardiovascular Diseases, Scientific Department, Fondazione IRCCS Policlinico San Matteo , Pavia , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukio","family":"Ozaki","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Fujita Health University Hospital , Toyoake , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Prati","sequence":"additional","affiliation":[{"name":"UniCamillus, Saint Camillus International University of Health Sciences , Rome , Italy"},{"name":"Centro per la Lotta Contro L\u2019Infarto\u2014CLI Foundation , Rome , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2948-7994","authenticated-orcid":false,"given":"Eloisa","family":"Arbustini","sequence":"additional","affiliation":[{"name":"Transplant Research Area and Centre for Inherited Cardiovascular Diseases, Scientific Department, Fondazione IRCCS Policlinico San Matteo , Pavia , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michela","family":"Ferrari","sequence":"additional","affiliation":[{"name":"Transplant Research Area and Centre for Inherited Cardiovascular Diseases, Scientific Department, Fondazione IRCCS Policlinico San Matteo , Pavia , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,4,21]]},"reference":[{"key":"2023042117455229400_suad059-B1","doi-asserted-by":"crossref","first-page":"e523","DOI":"10.1161\/CIR.0000000000000564","article-title":"Spontaneous coronary artery dissection: current state of the science: a scientific statement from the American Heart Association","volume":"137","author":"Hayes","year":"2018","journal-title":"Circulation"},{"key":"2023042117455229400_suad059-B2","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1016\/j.cjca.2014.01.011","article-title":"Non-atherosclerotic coronary artery disease in young women","volume":"30","author":"Saw","year":"2014","journal-title":"Can J Cardiol"},{"key":"2023042117455229400_suad059-B3","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1161\/CIRCULATIONAHA.113.002054","article-title":"Pregnancy-associated acute myocardial infarction: a review of contemporary experience in 150 cases between 2006 and 2011","volume":"129","author":"Elkayam","year":"2014","journal-title":"Circulation"},{"key":"2023042117455229400_suad059-B4","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1007\/s00380-010-0088-y","article-title":"Simultaneous and spontaneous multivessel coronary artery dissection presenting as congestive heart failure","volume":"26","author":"Kim","year":"2011","journal-title":"Heart Vessels"},{"key":"2023042117455229400_suad059-B5","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1097\/PAF.0000000000000167","article-title":"Spontaneous coronary artery dissection: report of 3 cases and literature review hormonal, autoimmune, morphological factors","volume":"36","author":"Melez","year":"2015","journal-title":"Am J Forensic Med Pathol"},{"key":"2023042117455229400_suad059-B6","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1136\/hrt.2009.185157","article-title":"Non-atherosclerotic coronary artery disease associated with sudden cardiac death","volume":"96","author":"Hill","year":"2010","journal-title":"Heart"},{"key":"2023042117455229400_suad059-B7","first-page":"151","article-title":"Long-term follow-up of medically treated patients with spontaneous coronary artery dissection: a prospective, Swiss single-centre cohort study","volume":"23","author":"Seidl","year":"2021","journal-title":"Swiss Med Wkly"},{"key":"2023042117455229400_suad059-B8","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1016\/j.jemermed.2016.09.005","article-title":"Emergency department presentation of patients with spontaneous coronary artery dissection","volume":"52","author":"Lindor","year":"2017","journal-title":"J Emerg Med"},{"key":"2023042117455229400_suad059-B9","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1002\/ccd.25293","article-title":"Coronary angiogram classification of spontaneous coronary artery dissection","volume":"84","author":"Saw","year":"2014","journal-title":"Catheter Cardiovasc Interv"},{"key":"2023042117455229400_suad059-B10","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1016\/j.jcmg.2016.01.009","article-title":"Multimodality imaging for spontaneous coronary artery dissection in women","volume":"9","author":"Tweet","year":"2016","journal-title":"JACC Cardiovasc Imaging"},{"key":"2023042117455229400_suad059-B11","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1161\/CIRCINTERVENTIONS.114.001659","article-title":"Spontaneous coronary artery dissection: revascularization versus conservative therapy","volume":"7","author":"Tweet","year":"2014","journal-title":"Circ Cardiovasc Interv"},{"key":"2023042117455229400_suad059-B12","doi-asserted-by":"crossref","first-page":"1188","DOI":"10.1093\/eurheartj\/ehz007","article-title":"Canadian spontaneous coronary artery dissection cohort study: in-hospital and 30-day outcomes","volume":"40","author":"Saw","year":"2019","journal-title":"Eur Heart J"},{"key":"2023042117455229400_suad059-B13","doi-asserted-by":"crossref","first-page":"2099","DOI":"10.1253\/circj.CJ-14-0773","article-title":"Spontaneous coronary artery dissection","volume":"78","author":"Alfonso","year":"2014","journal-title":"Circ J"},{"key":"2023042117455229400_suad059-B14","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.carrev.2016.09.005","article-title":"IVUS and OCT guided primary percutaneous coronary intervention for spontaneous coronary artery dissection with bioresorbable vascular scaffolds","volume":"18","author":"Mahmood","year":"2017","journal-title":"Cardiovasc Revasc Med"},{"key":"2023042117455229400_suad059-B15","doi-asserted-by":"crossref","first-page":"1530","DOI":"10.1136\/heartjnl-2022-320830","article-title":"Clinical outcomes in spontaneous coronary artery dissection","volume":"108","author":"Garcia-Guimaraes","year":"2022","journal-title":"Heart"},{"key":"2023042117455229400_suad059-B16","doi-asserted-by":"crossref","first-page":"1585","DOI":"10.1016\/j.jacc.2022.08.759","article-title":"Canadian spontaneous coronary artery dissection cohort study: 3-year outcomes","volume":"80","author":"Saw","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"2023042117455229400_suad059-B17","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1161\/CIRCINTERVENTIONS.114.001676","article-title":"Coronary artery tortuosity in spontaneous coronary artery dissection: angiographic characteristics and clinical implications","volume":"7","author":"Eleid","year":"2014","journal-title":"Circ Cardiovasc Interv"},{"key":"2023042117455229400_suad059-B18","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1016\/j.jacc.2017.05.055","article-title":"Spontaneous coronary artery dissection associated with pregnancy","volume":"70","author":"Tweet","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"2023042117455229400_suad059-B19","first-page":"e29587","article-title":"Spontaneous coronary artery dissection associated with infertility treatment","volume":"14","author":"Iyasere","year":"2022","journal-title":"Cureus"},{"key":"2023042117455229400_suad059-B20","doi-asserted-by":"crossref","first-page":"1969","DOI":"10.1016\/j.cjca.2021.09.022","article-title":"Cardiovascular deaths in pregnancy: growing concerns and preventive strategies","volume":"37","author":"Keepanasseril","year":"2021","journal-title":"Can J Cardiol"},{"key":"2023042117455229400_suad059-B21","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1097\/HJH.0000000000002019","article-title":"First international consensus on the diagnosis and management of fibromuscular dysplasia","volume":"37","author":"Gornik","year":"2019","journal-title":"J Hypertens"},{"key":"2023042117455229400_suad059-B22","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.jcin.2012.08.017","article-title":"Spontaneous coronary artery dissection: prevalence of predisposing conditions including fibromuscular dysplasia in a tertiary center cohort","volume":"6","author":"Saw","year":"2013","journal-title":"JACC Cardiovasc Interv"},{"key":"2023042117455229400_suad059-B23","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/j.recesp.2018.06.003","article-title":"Spontaneous coronary artery dissection and hypothyroidism","volume":"72","author":"Camacho Freire","year":"2019","journal-title":"Rev Esp Cardiol (Engl Ed)"},{"key":"2023042117455229400_suad059-B24","doi-asserted-by":"crossref","first-page":"e001933","DOI":"10.1161\/CIRCGENETICS.117.001933","article-title":"Prospective cardiovascular genetics evaluation in spontaneous coronary artery dissection","volume":"11","author":"Kaadan","year":"2018","journal-title":"Circ Genom Precis Med"},{"key":"2023042117455229400_suad059-B25","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1038\/gim.2014.72","article-title":"Survival is affected by mutation type and molecular mechanism in vascular Ehlers-Danlos syndrome (EDS type IV)","volume":"16","author":"Pepin","year":"2014","journal-title":"Genet Med"},{"key":"2023042117455229400_suad059-B26","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCGEN.121.003527","article-title":"Exploring the genetic architecture of spontaneous coronary artery dissection using whole-genome sequencing","volume":"15","author":"Tarr","year":"2022","journal-title":"Circ Genom Precis Med"},{"key":"2023042117455229400_suad059-B27","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.ijcard.2020.08.076","article-title":"Systematic review and meta-analysis of the clinical characteristics and outcomes of spontaneous coronary artery dissection","volume":"322","author":"Franke","year":"2021","journal-title":"Int J Cardiol"},{"key":"2023042117455229400_suad059-B28","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1097\/MCA.0000000000001043","article-title":"Clinical implications of arterial hypertension in patients with spontaneous coronary artery dissection","volume":"33","author":"Alfonso","year":"2022","journal-title":"Coron Artery Dis"},{"key":"2023042117455229400_suad059-B29","doi-asserted-by":"crossref","first-page":"ytac125","DOI":"10.1093\/ehjcr\/ytac125","article-title":"Spontaneous coronary artery dissection, fibromuscular dysplasia, and biventricular stress cardiomyopathy: a case report","volume":"6","author":"Blazak","year":"2022","journal-title":"Eur Heart J Case Rep"},{"key":"2023042117455229400_suad059-B30","doi-asserted-by":"crossref","first-page":"e25775","DOI":"10.1097\/MD.0000000000025775","article-title":"A breastfeeding woman with spontaneous coronary artery dissection and possible Takotsubo syndrome: a case report","volume":"100","author":"Takeuchi","year":"2021","journal-title":"Medicine (Baltimore)"},{"key":"2023042117455229400_suad059-B31","first-page":"667","article-title":"Dissecting aneurysm of coronary artery in a woman aged 42: rupture","volume":"1","author":"Pretty","year":"1931","journal-title":"Br Med J"}],"container-title":["European Heart Journal Supplements"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurheartjsupp\/article-pdf\/25\/Supplement_B\/B7\/50061121\/suad059.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurheartjsupp\/article-pdf\/25\/Supplement_B\/B7\/50061121\/suad059.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T18:03:48Z","timestamp":1682100228000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurheartjsupp\/article\/25\/Supplement_B\/B7\/7135788"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,1]]},"references-count":31,"journal-issue":{"issue":"Supplement_B","published-online":{"date-parts":[[2023,4,21]]},"published-print":{"date-parts":[[2023,4,21]]}},"URL":"https:\/\/doi.org\/10.1093\/eurheartjsupp\/suad059","relation":{},"ISSN":["1520-765X","1554-2815"],"issn-type":[{"value":"1520-765X","type":"print"},{"value":"1554-2815","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,4,1]]},"published":{"date-parts":[[2023,4,1]]}}}